Medicaid Provider Training

Medicaid Training  

Below are the documents mentioned in the Medicaid Training Document

  1. W-1E application (Application for Benefits)
  2. W-1LTSS application (Spanish) (Long-term Care/Waiver Application)
  3. W-1ER application (Eligibility Re-determination)
  4. W-265 (Report of Admission or Discharge Rated Housing Facility/Residential Care Home)
  5. W-298 (Authorization for Disclosure of Information)
  6. W-1685 (Medical Insurance Information)
  7. W-849 (LLR form)
  8. W-300T19 (Title XIX Disability Determination - Medical Report)
  9. W-300MED (Medicaid for the Employed Disabled - Medical Report)
  10. W-303 (Client Supplement for Medical Information)
  11. W-303a (Permission to Share Medical Information)
  12. Medicaid Coverage Groups and Actions
  13. Fact Sheet - DDS Maintaining Medicaid Eligibility equals Waiver Eligibility
  14. MyAccount Guide
  15. MyAccount: Online Renewal Guide

Below are some additional documentation for your convenience.

  1. W1-QMB Application (Application for Medicare Savings Programs (QMB, SLMB, ALMB))
  2. QMBR Application (Medicare Savings Programs Re-determination)
  3. DDS Funeral Funds for DDS Individuals
  4. W-1J (page 13 of the W-1LTSS App, Long-term Care/Waiver Application)
  5. W-1LTSS Section N (pages 11 and 12 of the W-1LTSS App)
  6. W-35 (for employers) Certificate for Disclosure of Gross Wages, Salary or Commission Paid
  7. COLA 2024 Rated Housing Letter 
  8. Rent subsidy and DSS 2018 (currently still in effect)
  9. Spend Down Process
  10. Spend Down Approved Items
  11. Personal Needs Allowance and Disregard Breakdown
  12. ABLE Act 2-7-24

 

Connecticut Developmental Services

460 Capitol Avenue
Hartford Connecticut 06106